Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | IL |
NPI | 1033163332 |
---|---|
Provider Name | Dr. James W Collins JR. |
First Address | Chicago, IL 60614-3394 |
Second Address | Chicago, IL 60614-3394 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E18621 | (02) |